Expanding Understandings of Intersectional Stigma: examining experiences of adult survivors of childhood sexual exploitation (CSE)

• In Event: 20820 - Section on Medical Sociology Roundtables
  In Refereed Roundtable (90 minute): Table 15. Stigma

Abstract

This study explores the experiences and impact of intersectional stigma on adult survivors of childhood sexual exploitation (CSE), particularly in healthcare settings. While stigma research has historically focused on conditions like mental illness and HIV, scholars have increasingly recognized the complex ways in which stigma intersects across multiple marginalized identities. Survivors of CSE experience significant health disparities, many of which are exacerbated by discrimination within medical institutions. This study examines how intersectional stigma operates as both a barrier to healthcare access and a determinant of survivors’ overall well-being.
Through qualitative analysis of interviews with 35 diverse adult survivors of CSE, this research identifies key themes in their healthcare experiences. Participants described widespread discrimination, including the prioritization of substance use histories over urgent medical needs, dismissive treatment related to their past exploitation, and denial of essential healthcare services. Stigma surrounding addiction and sex work often resulted in inadequate or dehumanizing care, reinforcing distrust in medical providers and discouraging help-seeking behaviors. Survivors also reported a lack of trauma-informed practices, with providers failing to recognize signs of trafficking or ask critical questions about their safety.
The findings highlight how intersecting stigmas—including related to mental illness, substance use, gender, race, sexuality, and CSE history—compound health vulnerabilities and contribute to long-term physical and mental health consequences. By centering survivors’ voices, this research underscores the urgent need for healthcare interventions that acknowledge and address intersectional stigma. Trauma-informed, stigma-free care is essential to improving health outcomes for this population. This study advances theoretical understandings of stigma while offering practical insights for policymakers, healthcare providers, and advocates working to support CSE survivors.

Authors

• Alisa K. Lincoln, Northeastern University

• Amelia Wagner, Northeastern University

• Jennifer O'Brien, University of Texas, Austin

• Rebecca Pfeffer, RTI

• Carlos Cuevas, Northeastern University

• Amy Farrell, Northeastern University